My First OSCE In Uganda Was a Success!

This in not an official U.S. Department of State (DOS) blog and the views and information presented are my own and do not represent the Fulbright Program or the DOS.

It is hard to believe I’m already into my 3rd week here in Kampala on the last of my official Fulbright Specialist Program (FSP) Visits.  Although the grant was small, it has really helped me to really move forward my collaboration with my Ugandan partners to help them Advance Pharmacy Practice in Uganda. The FSP itself has only supported me for 6 weeks of the total of 12 weeks that I will have spent in Uganda, by the time I head home on November 23.  It is the support of Professor Odoi and Makerere University who have engaged in this vision with me that has provided the extra weeks of lodging and in-country transportation.  I am truly thankful for this opportunity!  Unfortunately, the FSP can’t be renewed and in order to take the project to the next level and maintain growth, I will have to find alternative funding.  At some point in the future I will discuss some options in another blog post.

In the Practice OSCE, I am portraying, Jane, a woman of my age who has a sinus infection and headache. This wasn't too far fetched since I had just suffered a migraine over the weekend.

In the Practice OSCE, I am portraying, Jane, a woman of my age who has a sinus infection and headache. This wasn’t too far fetched since I had just suffered a migraine over the weekend.

Today I want to tell you about the Practice OSCE that another faculty member and I ran on Monday. OSCE stands for Objective Structured Clinical Exam and this is a practical exam where students are assessed on the skills and knowledge they have been learning this term through the Pharmaceutical Care Skills Lab (PCSL) I have been teaching.  Every Monday in class they are presented with different patient case scenarios and they get in groups to role-play and practice being the pharmacist who interacts with the pretend patient and or healthcare provider.  Then the pharmacy students go to the Mulago Hospital during the week and work with real patients to hone these skills and get more practical experience.  Much of the time there have been preceptors at the hospital to help with this. Either Pharmacy Interns or Pharmacists, or the faculty or the American Guest Pharmacists have worked with the students. I think that most students have had a chance to work with one of these people. But, because there are only 5 Pharmacists and about 30 Pharmacy Interns in training at the hospital (although it is a 2000 bed hospital that is always overcrowded), the students have not always been able to receive guidance as I had hoped.  Still, though, I think they are learning a lot and most of the students are committed to improving their patient care skills and the level of care pharmacists can provide.

Another student portrays a pharmacist counseling the patient about the medications he just filled for her.

Another student portrays a pharmacist counseling the patient about the medications he just filled for her.

The OSCE is a way to formally assess these new skills.  Zubin Austin, from University of Toronto, who developed the method of OSCE’s, came to Wilkes University back in August to train the faculty of the Pharmacy School so we could implement this program to assess our students’ pharmaceutical care skills.  Fortunately, I was able to attend this 2 day session and have now used this method to develop an OSCE assessment for the PCSL in Uganda.  We decided to run a pilot yesterday for 2 reasons.  We wanted to first test our process and make sure the students were capable of completing each station in 7 min. Second of all we wanted the pharmacy students to “see” what this was all about so that they would be adequately prepared, and hopefully not as stressed, for the real event, which will occur at the end of next week.  The “real” event will contain 5 stations. This is the minimum Dr. Austin suggests for validity but even just 5 stations will take us 2 whole days. We need to get 75 students though each of the stations. We will have to train 5 standardized patients to accomplish this. This basically means we will have actors and actresses portray the patient using a standardized script. They will have to be taught the nuances ahead of time and try their best to replicate the scenarios exactly the same for all 75 students.  Ideally we would hire professional actors, as many US Medical Schools and Pharmacy Schools do, but we have no budget for this here in Uganda, so we will do the best we can with second year pharmacy students.  I have also had to give the faculty here a crash course in OSCE development so they can help make sure the scenarios are close to real-life and the standards are appropriate.

The practice OSCE on Monday went incredibly well and did exactly what it was supposed to do. We were able to identify some areas of weakness which will be corrected for the real event and the students got a sense of what this will be like.  Tomorrow I will be debriefing this OSCE, giving them information about how it is determined whether they Pass or Fail and the results from Monday’s Practice OSCE.  One thing that amazed me is how much can be accomplished in the 7 min we allot for each scenario. The timing was probably what worried me most because when this is practiced in PCSL class, the groups work together and are given much more time, sometimes up to an hour, to work through the cases. Of course, for assessment purposes, each OSCE case only tests a few skills, rather than the many that are often packed into the classroom cases.  I’m now eager to get working on the development of the real OSCE stations.  The ideas have been in my head awhile now, but it is time to buckle down get them on paper so the faculty review process can start.



About kbohan

Professor, Department of Pharmacy Practice Binghamton University School of Pharmacy and Pharmaceutical Sciences Binghamton, NY USA
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4 Responses to My First OSCE In Uganda Was a Success!

  1. Diane Hagen says:

    I am amazed at your work in Uganda and wish you continued success. I don’t know how you can do so much and also keeping us up to date on Caring Bridge about Ruth’s cancer fight. Three cheers–and prayers.


  2. Kafiri Rosemary says:

    Looking for OSCE training for nurses in Uganda
    Kindly help


    • kbohan says:

      OSCE training is a great idea for the nursing program, however I’m not able to assist. I am not based in Uganda and I only have a small amount of my time that I can donate to the pharmacy school, as that is my discipline. I can check with the nursing faculty back home to see if there is interest.


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